Within the health and long-term care service fields, a person's subjective evaluation of the quality of services is increasingly recognized as an important outcome of long-term care, arguably as important as physical or cognitive functioning. While considerable attention has been given to develop client satisfaction measures in acute care, no existing standardized measures are available to address this vital aspect of long-term care service delivery. The Specific Aims of the study are to: (l) use multicultural perspectives of service recipients to develop a measure of client satisfaction for the frail elderly receiving home and community- based services that will address specific services as well as general satisfaction with services received; (2) determine the factor structure of service satisfaction; (3) estimate the test- retest reliability and internal consistency reliability of the client satisfaction measure; (4) assess the validity of the client satisfaction measure in relation to: (a) factor and item structure; (b) independent ratings of in-home care quality by case managers and caregivers; (c) a previously developed global satisfaction measure; (d) a previously developed measure of subjective well- being; and (e) estimates of response bias; and (5) experimentally compare two alternative methods of administration of the measure: in-person structured interviews and self-administration. The development of the measure will be based on consumer-defined notions of in-home quality, including minority perspectives. Focus groups with African-American, Puerto Ricans and White elders will be convened to assure that diverse perspectives on the quality of home and community-based services are represented in the development of the measure. The instrument will be field-tested with a representative random sample of approximately 200 African- American, Puerto Rican and White recipients of in-home supportive services in Springfield, MA. factor analytic techniques will be used to assess the factor structure of the client satisfaction questionnaire. The test-retest reliability and internal consistency reliability of the client satisfaction questionnaire will also be assessed. The validity of the measure will be assessed in relation to: (a) structure and process measures of care; (b) independent ratings of care; (c) other satisfaction measures; and (d) health and other outcomes. An expert advisory panel of national experts will review all aspects of the development, field- test, and testing of the measure. The study offers the advantage of access to an ethnically diverse sample of community-dwelling disabled elders from an ongoing study of minorities and long-term care funded by NIA (AG11171).